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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376610178
Report Date: 01/23/2020
Date Signed: 01/23/2020 11:19:10 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CENICEROS,ALICIA FAMILY CHILD CAREFACILITY NUMBER:
376610178
ADMINISTRATOR:CENICEROS,ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 419-6552
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:14CENSUS: 1DATE:
01/23/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Alicia CenicerosTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Yolanda Baez, made an unannounced visit for the purpose of a Plan of Correction inspection. LPA met with Licensee, Alicia Ceniceros. During this visit there was 1 child in care (1 infant).

The following deficiencies were issued on 01/07/2020 and have been cleared effective today:

  • Section 102417(g)(7): Licensee has completely filled LIC 700 for child in care
  • Section 102417(m)(3): Licensee has obtained signature for LIC282 for child in care
  • Section 102418(g)(1): Licensee has completely filled PM286 for child in care
  • Section 102417(g)(4): Licensee has installed cabinet locks for bathroom to make all chemicals and cleaning products inaccessible

No further deficiencies were issued throughout today's inspection. Notice of Site Visit is to be posted for 30 days, LPA observed Licensee posting the Notice of Site Visit.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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